Les certificats médicaux et le juge des libertés en psychiatrie

LYON1-BU Santé (693882101) / SudocSudocFranceF

Politiques de déplacements urbains en Europe. Analyse comparative : Espagne, France, Grande Bretagne, Italie, Norvège, Suisse

Tous les pays européens sont confrontés à des degrés divers aux mêmes maux dans la gestion des déplacements urbains. Ceux-ci se nomment congestion, pollution, déficit public, ... Leurs effets ont globalement tendance à s'accroitre. Pour y faire face, les pays européens développent des stratégies différentes avec des fortunes diverses mais dans presque tous les cas en deçà des attentes de la populations. L'objectif de ce travail est de présenter ces différentes politiques au travers de l'analyse d'une ou deux agglomérations représentatives, souvent à titre exemplaire, de la politique menée dans le pays

Comparison of different extraction techniques to profile microRNAs from human sera and peripheral blood mononuclear cells

International audiencemicroRNAs (miRNAs) play crucial roles in major biological processes and their deregulations are often associated with human malignancies. As such, they represent appealing candidates as targets of innovative therapies. Another interesting aspect of their biology is that they are present in various biological fluids where, advantageously, they appear to be very stable. A plethora of studies have now reported their potential as biomarkers that can be used in diagnosis, prognosis and/or theranostic issues. However, the application of circulating miRNAs in clinical practices still requires the identification of highly efficient, robust and reproducible methods for their isolation from biological samples.In that context, we performed an independent cross-comparison of three commercially available RNA extraction kits for miRNAs isolation from human blood samples (Qiagen and Norgen kits as well as the new NucleoSpin miRNAs Plasma kit from Macherey-Nagel). miRNAs were further profiled using the Taqman Low Density Array technology

How Using Dedicated Software Can Improve RECIST Readings

Decision support tools exist for oncologic follow up. Their main interest is to help physicians improve their oncologic readings but this theoretical benefit has to be quantified by concrete evidence. The purpose of the study was to evaluate and quantify the impact of using dedicated software on RECIST readings. A comparison was made between RECIST readings without dedicated application vs. readings using dedicated software (Myrian® XL-Onco, Intrasense, France) with specific functionalities such as 3D elastic target matching and automated calculation of tumoral response. A retrospective database of 40 patients who underwent a CT scan follow up was used (thoracic/abdominal lesions). The reading panel was composed of two radiologists. Reading times, intra/inter-operator reproducibility of measurements and RECIST response misclassifications were evaluated. On average, reading time was reduced by 49.7% using dedicated software. A more important saving was observed for lung lesions evaluations (63.4% vs. 36.1% for hepatic targets). Inter and intra-operator reproducibility of measurements was excellent for both reading methods. Using dedicated software prevented misclassifications on 10 readings out of 120 (eight due to calculation errors). The use of dedicated oncology software optimises RECIST evaluation by decreasing reading times significantly and avoiding response misclassifications due to manual calculation errors or approximations

Moving the Dial on Airway Inflammation in Response to Trikafta® in Adolescents with Cystic Fibrosis

International audienceNo abstract availabl

Molecular Biomarkers for Weight Control in Obese Individuals Subjected to a Multiphase Dietary Intervention

Context: Although calorie restriction has proven beneficial for weight loss, long-term weight control is variable between individuals.Objective: To identify biomarkers of successful weight control during a dietary intervention (DI).Design, Setting, and Participants: Adipose tissue (AT) transcriptomes were compared between 21 obese individuals who either maintained weight loss or regained weight during the DI. Results were validated on 310 individuals from the same study using quantitative reverse transcription polymerase chain reaction and protein levels of potential circulating biomarkers measured by enzyme-linked immunosorbent assay.Intervention: Individuals underwent 8 weeks of low-calorie diet, then 6 months of ad libitum diet.Outcome Measure: Weight changes at the end of the DI.Results: We evaluated six genes that had altered expression during DI, encode secreted proteins, and have not previously been implicated in weight control (EGFL6, FSTL3, CRYAB, TNMD, SPARC, IGFBP3), as well as genes for which baseline expression differed between those with good and poor weight control (ASPN, USP53). Changes in plasma concentrations of EGFL6, FSTL3, and CRYAB mirrored AT messenger RNA expression; all decreased during DI in individuals with good weight control. ASPN and USP53 had higher baseline expression in individuals who went on to have good weight control. Expression quantitative trait loci analysis found polymorphisms associated with expression levels of USP53 in AT. A regulatory network was identified in which transforming growth factor β1 (TGF-β1) was responsible for downregulation of certain genes during DI in good controllers. Interestingly, ASPN is a TGF-β1 inhibitor.Conclusions: We found circulating biomarkers associated with weight control that could influence weight management strategies and genes that may be prognostic for successful weight control

Transcriptome profiling from adipose tissue during a low-calorie diet reveals predictors of weight and glycemic outcomes in obese, nondiabetic subjects

Background: A low-calorie diet (LCD) reduces fat mass excess, improves insulin sensitivity, and alters adipose tissue (AT) gene expression, yet the relation with clinical outcomes remains unclear.Objective: We evaluated AT transcriptome alterations during an LCD and the association with weight and glycemic outcomes both at LCD termination and 6 mo after the LCD.Design: Using RNA sequencing (RNAseq), we analyzed transcriptome changes in AT from 191 obese, nondiabetic patients within a multicenter, controlled dietary intervention. Expression changes were associated with outcomes after an 8-wk LCD (800-1000 kcal/d) and 6 mo after the LCD. Results were validated by using quantitative reverse transcriptase-polymerase chain reaction in 350 subjects from the same cohort. Statistical models were constructed to classify weight maintainers or glycemic improvers.Results: With RNAseq analyses, we identified 1173 genes that were differentially expressed after the LCD, of which 350 and 33 were associated with changes in body mass index (BMI; in kg/m(2)) and Matsuda index values, respectively, whereas 29 genes were associated with both endpoints. Pathway analyses highlighted enrichment in lipid and glucose metabolism. Classification models were constructed to identify weight maintainers. A model based on clinical baseline variables could not achieve any classification (validation AUC: 0.50; 95% CI: 0.36, 0.64). However, clinical changes during the LCD yielded better performance of the model (AUC: 0.73; 95% CI: 0.60, 0.87]). Adding baseline expression to this model improved the performance significantly (AUC: 0.87; 95% CI: 0.77, 0.96; Delong's P = 0.012). Similar analyses were performed to classify subjects with good glycemic improvements. Baseline-and LCD-based clinical models yielded similar performance (best AUC: 0.73; 95% CI: 0.60, 0.86). The addition of expression changes during the LCD improved the performance substantially (AUC: 0.80; 95% CI: 0.69, 0.92; P = 0.058).Conclusions: This study investigated AT transcriptome alterations after an LCD in a large cohort of obese, nondiabetic patients. Gene expression combined with clinical variables enabled us to distinguish weight and glycemic responders from nonresponders. These potential biomarkers may help clinicians understand intersubject variability and better predict the success of dietary interventions.</p